The present invention relates to a surgical system and method by which a diseased or defective site of a hollow organ of a living body (hereinafter “body”) is resected after which the cut-end sections of the hollow organ are stapled, and particularly relates to a system and method for use in Natural Orifice Transluminal Endoscopic Surgery (Hereinafter “NOTES”) which reduces the invasiveness of surgical procedures by eliminating the need for large-scale surgery, such as that involving a conventional abdominal incision.
Previously, in surgery in which a diseased or defective site of a hollow organ, for example a digestive tract, is resected so that the cut-end sections of the remainder of the tract are stapled, as in lesion-resection surgery of an intestinal tract, including cancer resection, there is no choice but to incise the abdomen from the outside of the body and to resect the lesion from outside of the lesion, and then to staple the cut-end sections from the outside thereof. Recently, as described below, a surgical method has been proposed and utilized in which the respective end sections of a diseased or defective site of an intestinal tract are cut off by using a linear-cutting/stapling device (linear stapler) (hereinafter “linear stapler”) in such a way that the respective end sections are cut linearly in the transverse direction from the outside, and at the same time the cut-end sections of the remainder of the intestinal tract are closed by purse-string-like linear-stapling suturing, after which a circular anastomotic surgical stapler is used to staple the two cut-end sections of the remainder of the intestinal tract, and at the same time the cut-end sections of the remainder of the intestinal tract that have been closed by purse-string-like linear-stapling suturing are cut off.
In the following explanation, in a body's natural orifice or separately made endoscopic hole that is made so that endoscopic instruments can be inserted into the body (hereinafter “endoscopic hole”), the portion of the device or the part of a body in the body's inward direction is called the “front end” or “front section,” and the portion of the device or the part of the body in the body's outward direction is called the “rear end” or “rear section.”
An existing circular anastomotic surgical stapler, for example as illustrated in FIG. 39 (prior art), includes: (1) a head assembly for ligation 1060 that has an anvil component 1000 at the front end; (2) a head component 1061 that is positioned opposite to the anvil component 1000 and that has anastomotic staples and a circular cutter used for circular anastomosis of the two cut-end sections of the hollow organ; (3) a shaft assembly 1050, which is an insertion body to be inserted into the hollow organ, and which has a long, flexible support shaft 1070; (4) an actuator hand assembly 1086 that is connected to the shaft assembly 1050 and that controls the driving of the circular cutter and anastomotic staples; and wherein the anvil component 1000 is constructed so that it is releasably mounted to the head component 1061 via an anvil shaft 1104 and a trocar portion (not shown) that is connected thereto. (See, e.g., FIGS. 5-47 of Patent Document 1.)
In contrast, as illustrated in FIG. 40 (prior art), an existing linear stapler 1500 includes: (1) an end effector 1503 that has an upper jaw 1504 that opens and closes, and a lower jaw 1505 that is positioned opposite to the upper jaw 1504 and that has one or more linear rows of staples and a linear cutter; (2) an insertion body 1501, to be inserted via an endoscopic hole, that has a long, flexible support shaft 1506 connected to the end effector 1503; and (3) an operating assembly 1502 that is connected to the support shaft 1506 and that controls the driving of one or more linear rows of staples and of the linear cutter. (See, e.g., FIG. 1 of Patent Document 2.)